A concept of schizophrenia

Abstract

As a medical student, I accepted the idea of schizophrenia as a disease analogous to the serious bodily conditions I was learning about at the time. Although at that time I did not make any attempt to define what was meant by disease in this context, later consideration of the issues led me to the conclusion that when the medical model of shizophrenia as a disease is proposed, the term is used as a combination of disease as a syndrome and disease as a lesion, using the classification described by Kendell. Evidence is then put forward to support the case that (a) the signs and symptoms regarded as typical of shizophrenia form a syndrome picture that has a characteristic outcome and (b) there is likely to be an underlying morbid psychiatric physical condition in the disorder. It is concluded that the evidence that shizophrenia is a biological disease is strong, but it is suggested that even if this idea should turn out to have been mistaken, the medical model of shizophrenia as a disease will still have been of substantial practical value to patients and clinicians.